Pregnancy outcome in women with low midtrimester maternal serum unconjugated estriol
Santolaya-Forgas, J.; Jessup, J.; Burd, L.I.; Prins, G.S.; Burton, B.K.
Journal of Reproductive Medicine 41(2): 87-90
1996
ISSN/ISBN: 0024-7758 PMID: 8656420 Document Number: 460262
OBJECTIVE: To determine if unexplained low second-trimester maternal serum unconjugated estriol (MSuE3) in a useful predictor of complications of pregnancy. STUDY DESIGN: Between February 1, 1990, and January 3, 1993, 10,492 patients underwent prenatal screening using second-trimester maternal serum alpha-fetoprotein (MSAFP), maternal serum human chorionic gonadotropin (MShCG) and MSuE3. One hundred ninety-five patients with complete obstetric history/delivery records and with lt 0.04 multiples of the median (MoM) second-trimester MSuE3 values were matched with 261 controls with complete obstetric history/delivery records and normal second-trimester MSAFP, MSuE3 and MShCG. RESULTS: The relative risk of pregnancy loss, as compared to that in controls, was 3.7 (1.4-9.1 confidence interval (CI), P lt .0001) in patients with 0.2-0.4 MoM MSuE3 and 19.3 (6.1-60.5 CI, P lt .0001) in patients with lt 0.2 MoM MSuE3. After exclusion of patients with low and high MSAFP and MShCG, the relative risk of pregnancy loss for the remaining patients with low MSuE3 was 3.3 (1.3-8.5 CI, P lt .008). CONCLUSION: The data suggest that patients with unexplained low second-trimester MSuE3 have an increased risk of pregnancy loss that may not be associated with a high or low MSAFP, MShCG or higher incidence of pregnancy-induced hypertension, gestational diabetes, premature rupture of membranes or premature onset of labor.